Johanna Viitanen

Physicians’ experiences of participation in healthcare IT development in Finland: Willing but not able

OBJECTIVE To learn (1) about the kind of experiences that physicians have with participation in healthcare IT development; (2) whether physicians are interested in participating in IT development activities, and if so, how; and (3) the visions that physicians have regarding future IT systems. METHODS A web-based questionnaire which was answered by about one-third of the working-age physicians in Finland, which is exceptionally broad and sizeable a sample. This research deals with only a small part of the entire questionnaire. The questions used for this study were both quantitative and qualitative. Statistical methods were applied to the former and content analysis to the latter. RESULTS The responding physicians were highly critical of their IT systems, and their experiences with the current methods of participation, or rather the lack of it, were quite negative. However, a very significant proportion of the respondents were willing to contribute to IT systems development, contrary to a common assumption that clinicians are disinterested. Visioning of future systems was quite cautious, dealing mainly with usability improvements to the current systems. CONCLUSIONS Major improvements are needed both in the usability of the systems currently in use in Finland and in the collaboration between end-users and developers. Improved methods of participation need to be developed and applied, particularly for the procurement, deployment and on-going development of commercial-off-the-shelf applications.

Finnish physicians' experiences with computer-supported patient information exchange and communication in clinical work.

Several researchers share the concern of healthcare information systems failing to support communication and collaboration in clinical practices. The objective of this paper is to investigate the current state of computer-supported patient information exchange and associated communication between clinicians. We report findings from a national survey on Finnish physicians? experiences with their currently used clinical information systems with regard to patient information documentation, retrieval, management and exchange-related tasks. The questionnaire study with 3929 physicians indicated the main concern being cross-organisational patient information delivery. In addition, physicians argued computer usage increasingly steals time and attention from caring activities and even disturbs physician?nurse collaboration. Problems in information management were particularly emphasised among those physicians working in hospitals and wards. The survey findings indicated that collaborative applications and mobile or wireless solutions have not been widely adapted in Finnish healthcare and suggested an urgent need for adopting appropriate information and communication technology applications to support information exchange and communication between physicians, and physicians and nurses.

Redesigning digital dictation for physicians: A user-centred approach

The user-centred approach has proven its success in software and product development. However, in the healthcare domain, user-centred research methodology has been applied less widely. This article reports a study that employs a contextual inquiry method to study the prevailing dictation procedures and solutions in a hospital from the physician’s perspective. The goal was to empirically evaluate digital dictation and the other three currently used methods for making dictations, thereby eliciting information for supporting the hospital administration in their decisions concerning the further development of a dictation solution. The research indicated a number of user requirements for a dictation solution. The main conclusions were: (1) the currently used information systems need extensive improvements and redesign; (2) the observed process of digital dictation does not seem applicable for its intended context of use; (3) for future solutions, it is important to understand that the dictation user interface cannot be standardized.

Usability evaluation of digital dictation procedure - an interaction analysis approach

This paper introduces a usability study of digital dictation procedure in which a task-originating modelling method, called interaction sequence illustration (ISI), was used for analysing interaction steps and stages. The analysis was conducted from the physicians viewpoint in a real-life clinical environment. Study results showed that the observed process of digital dictation is inefficient and unnecessarily lengthy. The analysis also revealed a number of interaction design failures and complex interaction sequences. In the study the ISI approach is suitable for providing concrete and detailed information about the steps and stages of interaction, the usability of user interfaces, and the success of interaction design.

International remote usability evaluation: the bliss of not being there

This paper describes the planning and implementation of a cross-border usability test that was to be executed in five European countries. The usability evaluation was designed by the Usability Group at Helsinki University of Technology who also performed the testing for the Finnish partner. In the other countries the usability tests were to be implemented by teams of subject matter specialists with very heterogeneous disciplines ranging from software engineering to social sciences, gender equality and vocational counselling. This paper describes the level of materials and training prepared for the remote usability testing and discusses its adequacy both via test personnel satisfaction and comments, and by comparing the found usability problems and observed phenomena in the test sessions between the test executed by the usability experts and the subject matter specialists.

Analysis of Emergent Use for Wellbeing Service Innovation

This paper presents a process of concept development for a new physical activity monitoring device. It forms part of a collaboration project between a Finnish health-technology company and Aalto University’s Department of Computer Science and Engineering. There are two main objectives in this project; to develop and validate concepts for the company’s product and to evaluate user interfaces that were built on the basis of these concepts. This will result in a set of new ideas for using and improving the service. The paper presents the results from the first and second phases of this three phase project. The first phase focuses on requirements from the health-technology company and how these were considered. Through an iteration process a set of three concepts were derived. In phase 2, these three concepts are visualized via storyboards. In phase 2, prototypes that were designed on the basis of the requirements are also assessed.